Laparoscopic, Endoscopic and Robotic Surgery (Sep 2020)
Comparison of endoscopic tympanoplasty to microscopic tympanoplasty in anterior tympanic membrane perforation
Abstract
Objective: Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media. This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty (ET) and microscopic tympanoplasty (MT) in anterior tympanic membrane perforation. Methods: The clinical data of 42 patients undergoing tympanoplasty with anterior quadrants tympanic membrane perforation between January 2018 and July 2019 were retrospectively analyzed. Patients were classified into the ET group (n = 22) or the MT group (n = 20). Patients’ demographics, clinical characteristics, surgical and functional outcomes were assessed between the two groups. Results: External auditory canal widening was not necessary in the ET group and was performed in 55.0% of patients in the MT group. The operation time of the ET group was significantly shorter than that of the MT group (61.23 ± 11.48 min vs. 78.65 ± 11.79 min, p = 0.034). The pain scale score of the ET group at 24 hours after surgery was significantly lower than that of the MT group (0.86 ± 0.64 vs. 2.40 ± 1.14, p = 0.029). The grafting success rate was 95.5% (21/22) in the ET group and 95.0% (19/20) in the MT group. In the ET group, the pre- and postoperative air-bone gap were 35.60 ± 8.43 dB and 18.79 ± 5.80 dB, respectively, which was a significant improvement (p = 0.016). The respective values in the MT group (33.33 ± 7.88 dB and 19.58 ± 6.24 dB) also represented a significant improvement (p = 0.004). Conclusion: ET is more beneficial for patients with anterior tympanic membrane perforations, which helps minimize the surgical trauma and reduces operation time and postoperative pain.
